Pneumonia Flashcards
How can you diagnose pneumonia?
Signs of lower respiratory tract infections (fever/cough/phlegm/crepitations or bronchial breathing) + CXR changes
What is CAP?
Community acquired pneumonia
- Infection that has been acquired without any contact with healthcare services
What is HAP?
Hospital acquired pneumonia
- New onset of symptoms along with a compatible x-ray developing >48 hours after the patient’s admission to hospital
What are the sub-categories of HAP?
Early onset
- Within 4-5 days of admission
- More likely to be antibiotic-sensitive bacteria
Late onset
- > 5 days of admission
- More likely to be antibiotic resistant bacteria
What is VAP?
Ventilator associated pneumonia
- Occurs in patients on mechanical ventilation
What are the typical causes of CAP?
o Streptococcus Pneumoniae (most common) o Haemophilus influenzae o Moraxella catarrhalis o Klebsiella pneumoniae o Staphylococcus aureus o Viruses
Mainly gram +ve cocci
What are the atypical causes of CAP?
Legions of psittaci MCQs -> atypical pneumonia • Legionella pneumophila • Chlamydophila Psittaci • Mycoplasma pneumoniae • Chlamydophila pneumoniae • Q-fever (Coxiella burnetiii)
What viruses commonly cause CAP?
- Influenza A and B
- Adenovirus
- Para-influenzae
- Respiratory synctal virus
- SARS-CoV-2
What is distinctive about legionella species?
- Caused by infected water supplies or air conditioning units (holiday)
- Causes SIADH which causes Hypotranaemia
What is distinctive about mycoplasma pneumoniae?
- Causes erythema multiforme
- Tends to effect younger patients
What is distinctive about chlamydia pneumoniae?
- Occurs in outbreaks in families and institutions
- Extremities of age vulnerable
What is distinctive about coxiella burnetii?
- Exposure to animals and bodily fluids
What is distinctive about chylamydia psittaci?
- Infected birds
- Can occasionally cause hepatosplenomegaly
How do you treat atypical CAP organisms?
Macrolides
- Need to be treated with antibiotics which act in intracellular space as they do not have a cell wall (penicillin and cephalosporins act on the cell wall)
What are the common causes of late-onset HAP?
o Staphylococcus Aureus (including MRSA)
o Enterobacteria: E. coli, Klebsiella sp., Enterobacter sp., Serratia
o Pseudomonas sp.
o Environmental gram negatives: Acinetobacter ap., Stenotrophomonas, maltophilia